Exophytic focal nodular hyperplasia torsion: A rare cause of sudden-onset epigastric pediatric abdominal pain Justin Lee, Mark Molitor, Mouied Alashari,

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Presentation transcript:

Exophytic focal nodular hyperplasia torsion: A rare cause of sudden-onset epigastric pediatric abdominal pain Justin Lee, Mark Molitor, Mouied Alashari, William Winters, David E. Skarda Journal of Pediatric Surgery Case Reports Volume 2, Issue 9, Pages 407-409 (September 2014) DOI: 10.1016/j.epsc.2014.08.010 Copyright © 2014 The Authors Terms and Conditions

Fig. 1 Coronal CT image through mid-abdomen shows an oval mass between the contrast-filled stomach and left lobe of liver. Journal of Pediatric Surgery Case Reports 2014 2, 407-409DOI: (10.1016/j.epsc.2014.08.010) Copyright © 2014 The Authors Terms and Conditions

Fig. 2 H&E stain showing fibrotic portal region with abnormally thick artery, occasional bile ducts, and mixed inflammatory infiltrate. Journal of Pediatric Surgery Case Reports 2014 2, 407-409DOI: (10.1016/j.epsc.2014.08.010) Copyright © 2014 The Authors Terms and Conditions

Fig. 3 Trichrome stain showing expended and fibrotic portal region with multiple blood vessels. Journal of Pediatric Surgery Case Reports 2014 2, 407-409DOI: (10.1016/j.epsc.2014.08.010) Copyright © 2014 The Authors Terms and Conditions

Fig. 4 Coronal CT image through mid-abdomen shows an oval mass projecting to the left of the left hepatic lobe. Journal of Pediatric Surgery Case Reports 2014 2, 407-409DOI: (10.1016/j.epsc.2014.08.010) Copyright © 2014 The Authors Terms and Conditions

Fig. 5 Sonographic image shows the mass (outlined by cursors). Its appearance by ultrasound is similar to normal liver. Journal of Pediatric Surgery Case Reports 2014 2, 407-409DOI: (10.1016/j.epsc.2014.08.010) Copyright © 2014 The Authors Terms and Conditions

Fig. 6 Gross bisected specimen showing diffuse hemorrhagic necrosis with a central stellate-shaped scar. Journal of Pediatric Surgery Case Reports 2014 2, 407-409DOI: (10.1016/j.epsc.2014.08.010) Copyright © 2014 The Authors Terms and Conditions

Fig. 7 H&E stain showing irregular fibrous thickening with abnormal blood vessels in a background of hemorrhagic necrosis. Journal of Pediatric Surgery Case Reports 2014 2, 407-409DOI: (10.1016/j.epsc.2014.08.010) Copyright © 2014 The Authors Terms and Conditions